265P - Multi-parametric magnetic resonance imaging-based nomogram for predicting prostate cancer and high-grade prostate cancer in men undergoing repeat p...

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Prostate Cancer
Genitourinary Cancers
Imaging, Diagnosis and Staging
Presenter Cong Huang
Citation Annals of Oncology (2017) 28 (suppl_10): x77-x80. 10.1093/annonc/mdx662
Authors C. Huang
  • Department Of Urology, Peking University First Hospital, 100034 - Beijing/CN

Abstract

Background

To develop and internally validate nomograms based on multi-parametric magnetic resonance imaging (mpMRI) to predict prostate cancer (PCa) and high-grade prostate cancer (HGPCa) in patients with a previous negative prostate biopsy.

Methods

The present study included 231 patients who underwent repeat prostate biopsy after an initial negative biopsy between January 2001 and April 2017 at our institution. The clinicopathological data analysed included age, body mass index, prostate-specific antigen (PSA), free/total PSA ratio, prostate volume (PV), PSA density, PSA velocity, digital rectal examination (DRE), transrectal ultrasound and mpMRI results. Based on Prostate Imaging and Reporting Data System (PI-RADS) version 2 scoring, the mpMRI results were assigned a PI-RADS grade from 0–2. Two logistic regression nomograms for predicting the probabilities of PCa and HGPCa were constructed. The performances of the nomograms were assessed using area under the receiver operating characteristic curves (AUCs), calibrations and decision curve analysis.

Results

Of the total cohort of patients, on repeat biopsy PCa was detected in 75 (32.5%) and HGPCa was detected in 59 (25.5%). In multivariate logistic regression analysis, age, PSA, PV, DRE and mpMRI results were significant independent predictors of the diagnosis of PCa and the diagnosis of HGPCa (all p < 0.05). Two mpMRI-based nomograms with super predictive accuracy were constructed (AUCs = 0.878 and 0.927, both p < 0.001), and both exhibited excellent calibration. Decision curve analysis also demonstrated a high net benefit across a wide range of probability thresholds.

Conclusions

mpMRI combined with age, PSA, PV and DRE can predict the probability of PCa and HGPCa in patients with negative initial biopsies. The two nomograms generated may aid the decision-making process in men with prior benign histology before the performance of repeat biopsy.

Clinical trial identification

Legal entity responsible for the study

Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center of China, Beijing, China.

Funding

None

Disclosure

The author has declared no conflicts of interest.